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The skin of my lower legs is turning brown. What can be done about it?

Question:

For the past few years, I have noticed that the skin of my legs near the ankles has been getting darker. It is not painful. My doctor told me that there is nothing that can be done about this. Is this a vascular problem or a skin problem?

Answer:

Brown discoloration of the lower legs is called stasis pigmentation and is a sign of high pressure in the leg veins. A vascular evaluation is needed to determine which veins are causing the problem. If the superficial veins are "incompetent” due to weak valves, the treatment can be closure of the superficial veins with a laser or removal of the veins by a surgical procedure. If the deeper veins are the cause of the problem, the treatment is usually support stockings. There are many "bleaching creams" sold that claim to fade the darkened skin but I do not have any evidence that they make a significant difference. If the vein problem causing the darkening is corrected, the discoloration does fade with time - in my experience.